0000000000384358

AUTHOR

Peter C. Smith

0000-0003-0058-7588

showing 3 related works from this author

What is the impact of rerouting a cancer diagnosis from emergency presentation to GP referral on resource use and survival? Evidence from a populatio…

2018

Background Studies on alternative routes to diagnosis stimulated successful policy interventions reducing the number of emergency diagnoses and associated mortality risk. A dearth of evidence on the costs of such interventions might prevent new policies from achieving more ambitious targets. Methods We conducted a retrospective cohort study on the population of colorectal (88,051), breast (90,387), prostate (96,219), and lung (97,696) cancer patients diagnosed after a GP referral or an emergency presentation and reported in the Cancer Registry of England. Resource use and survival were compared 1 year before and 5 years after diagnosis (3 years for lung), including the costs of GP referrals…

Emergency Medical ServicesCancer ResearchSurvival0302 clinical medicineNeoplasmsEmergency medical services1306030212 general & internal medicineMedical diagnosisReferral and Consultationeducation.field_of_study1311Health Care CostsEarly diagnosilcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogensPrognosisEarly diagnosisPrimary careRoute to diagnosisRoute to diagnosiOncologyPopulation Surveillance030220 oncology & carcinogenesisHealth ResourcesHospital costResearch Articlemedicine.medical_specialty2730ReferralEarly diagnosis; Emergency; Hospital costs; Primary care; Route to diagnosis; Survival; Oncology; Genetics; Cancer ResearchPopulationlcsh:RC254-28203 medical and health sciencesGeneticGeneral PractitionersGeneticsmedicineHumanseducationLung cancerbusiness.industryCancerRetrospective cohort studymedicine.diseaseCancer registryEmergency medicineEmergencyHospital costsbusinessNeoplasms/diagnosis
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Do Reduced Hospital Mortality Rates Lead to Increased Utilization of Inpatient Emergency Care?:A Population-Based Cohort Study

2018

OBJECTIVES: To measure the impact of the improvement in hospital survival rates on patients' subsequent utilization of unplanned (emergency) admissions.DATA SOURCES/STUDY SETTING: Unplanned admissions occurring in all acute hospitals of the National Health Service in England between 2000 and 2009, including 286,027 hip fractures, 375,880 AMI, 387,761 strokes, and 9,966,246 any cause admissions.STUDY DESIGN: Population-based retrospective cohort study. Unplanned admissions experienced by patients within 28 days, 1 year, and 2 years of discharge from the index admission are modeled as a function of hospital risk-adjusted survival rates using patient-level probit and negative binomial models. …

Malemedicine.medical_specialtyPopulationHospital mortality030204 cardiovascular system & hematologyPlacebo03 medical and health sciencesPopulation based cohort0302 clinical medicinePatient Admissionhealth care costsMedicineHumans030212 general & internal medicineHospital MortalityhospitalLead (electronics)educationStrokeRisk adjustment for resource use or payment2719AgedRetrospective StudiesHip fractureeducation.field_of_studyInpatientsResource Usebusiness.industryHealth Policyhealth care costRetrospective cohort studyMiddle AgedPatient Acceptance of Health Carequality of care/patient safety (measurement)medicine.diseasePatient DischargeHospitalizationEnglandSettore SECS-P/03 - Scienza Delle FinanzeEmergency medicineFemalebusinessEmergency Service HospitalhospitalsResearch Article
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Hospital readmission rates: signal of failure or success?

2013

AbstractHospital readmission rates are increasingly used as signals of hospital performance and a basis for hospital reimbursement. However, their interpretation may be complicated by differential patient survival rates. If patient characteristics are not perfectly observable and hospitals differ in their mortality rates, then hospitals with low mortality rates are likely to have a larger share of un-observably sicker patients at risk of a readmission. Their performance on readmissions will then be underestimated. We examine hospitals’ performance relaxing the assumption of independence between mortality and readmissions implicitly adopted in many empirical applications. We use data from th…

MaleMORTALITY-RATESEconomicsIMPACTSocial SciencesHospital performanceC50Business & EconomicsReadmission ratesmedia_commonAged 80 and overHip fractureOUTCOMESI18Mortality rateHealth PolicyHEALTH CARE SCIENCES & SERVICESHospitalsSurvival RateEngland1117 Public Health And Health ServicesMortality ratesFemaleMedical emergencyHEALTHLife Sciences & BiomedicineSample selectionmedicine.medical_specialtyACUTE MYOCARDIAL-INFARCTIONmedia_common.quotation_subjectBivariate analysisPatient ReadmissionReadmission ratemedicineQUALITYHumansSurvival rate1402 Applied EconomicsSelection (genetic algorithm)AgedQuality of Health CareSelection biasHospital readmissionSAMPLE SELECTIONScience & TechnologyModels Statisticalbusiness.industryHip FracturesPublic Health Environmental and Occupational HealthHIP FRACTUREHEALTH POLICY & SERVICESmedicine.diseaseMortality rateMODELEmergency medicinebusinessRACOSTS
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